Study On The Relationship Between Sleep Quality And Common Complications During Pregnancy

ObjectiveTo investigate the sleep quality in different stages of pregnancy,analyze the differences of sleep quality in pregnant women with different characteristics during pregnancy,and explore the correlation between sleep quality in pregnancy and pregnancy complications.MethodsA cross-sectional study and a nested cohort study were used in this study approved by the Ethics Committee.Pregnant women enrolled signed informed consent and were enrolled at Anhui Maternal and Child Health Hospital from November 1,2020 to July31,2022.A total of 334 pregnant women with demographic characteristics,life factors questionnaire,Pittsburgh Sleep Quality Index（PSQI）at 11-13⁺⁶ weeks of gestation,24-27⁺⁶ weeks of gestation,28-36⁺⁶ weeks of gestation and complete pregnancy outcome were included.The Pittsburgh Sleep Quality Index（PSQI）of the first,second,and third trimesters of pregnancy was extracted from the birth cohort information collection system.As well as basic demographic characteristics,pregnancy characteristics,living and working habits and environmental exposures（including age,place of residence,education,BMI,previous pregnancy history,dysmenorrhea,smoking history,passive smoking history,premarital check-up,early pregnancy reactions,vaginal bleeding in early pregnancy,participation in work,etc）,Data of pregnancy complications（including gestational hypertension,preeclampsia,gestational diabetes,preeclampsia,fetal distress,premature rupture of membranes,premature delivery,macrocephaly,umbilical cord around the neck）were extracted from HIS system of Anhui Maternal and Child Health Hospital.To understand the sleep quality of pregnant women with different characteristics during pregnancy,c²-test was used to analyze the correlation between different population characteristics,pregnancy characteristics,life,work habits,environmental exposure factors and sleep quality during pregnancy.Multivariate logistic regression was used to analyze the risk factors and protective factors related to poor sleep quality during pregnancy.c²-test was used to analyze the correlation between sleep quality and common complications during pregnancy.Results1.Sleep quality during pregnancyA total of 334 pregnant women were included in this study.The PSQI of the first trimester was（5.52±2.64）points,and the incidence of poor sleep quality during pregnancy was 45.51%;the PSQI of the second trimester was（5.07±2.83）points;the incidence of poor sleep quality during pregnancy was 37.41%;the PSQI of the third trimester was（5.74±3.12）points.The incidence of poor sleep quality in this pregnancy was 47.31%,68.56%had poor sleep quality in at least one pregnancy,and 21.26%had poor sleep quality throughout the whole pregnancy.2.Single factor analysisAnalysis of population characteristics and life factors related to sleep quality in early pregnancy:Appetite in early pregnancy（c²=10.647,P<0.01）,constipation（c²=6.703,P<0.010）,smoking history（c²=8.641,P<0.01）,noise（c²=6.876,P<0.01）,smoking in the 3 months before pregnancy（c²=4.265,P<0.05）,secondhand smoke in early pregnancy（c²=3.991,P<0.05）,household smoking in early pregnancy（c²=3.871,P<0.05）,work in early pregnancy（c²=4.794,P<0.05）.Analysis of population characteristics and life factors related to sleep quality in the second trimester:History of dysmenorrhea（c²=9.422,P<0.01）,pre-pregnancy weight classification（c²=10.927,P<0.01）,smoking history（c²=7,P<0.01）,noise（c²=6.854,P<0.01）,secondhand smoke in early pregnancy（c²=9.816,P<0.01）,smoking in the first trimester（c²=17.217,P<0.001）,working in the first trimester（c²=7.634,P<0.01）.Analysis of population characteristics and life factors related to sleep quality in the third trimester:Previous pregnancy history（c²=5.877,P<0.05）,premarital examination（c²=5.025,P<0.05）,constipation（c²=5.126,P<0.05）,eating regularity in early pregnancy（c²=6.735,P<0.05）,noise（c²=4.844,P<0.05）,secondhand smoke in the 3months before pregnancy（c²=4.324,P<0.05）,secondhand smoke in the first trimester（c²=11.606,P<0.01）,secondhand smoke in the first trimester（c²=9.864,P<0.01）,secondhand smoke in the second trimester（c²=4.209,P<0.05）,work intensity in the 3months before pregnancy（c²=9.803,P<0.05）.Analysis of population characteristics and life factors affecting sleep quality during pregnancy:Constipation（c²=4.457,P<0.05）,smoking history（c²=5.214,P<0.05）,eating regularity in early pregnancy（c²=10.031,P<0.01）,noise（c²=7.337,P<0.01）,secondhand smoke in early pregnancy（c²=9.918,P<0.01）,household smoking in the first trimester（c²=14.228,P<0.01）,secondhand smoke in the second trimester（c²=5.409,P<0.05）,and work in the first trimester（c²=4.435,P<0.05）.3.Multi-factor logistic regression analysisStatistically significant indicators of univariate analysis were incorporated into the multivariate logistic regression analysis model at each gestational week,and the results showed that constipation（OR=1.751 95%CI:1.091～2.809）and noise（OR=1.79095%CI:1.065～3.009）were risk factors affecting sleep quality in early pregnancy.Women with poor appetite in early pregnancy had a higher risk of poor sleep quality than those with normal appetite（OR=2.343 95%CI:1.266～4.336）.Dysmenorrhea（OR=2.059 95%CI:1.248～3.399）,noise（OR=2.05195%CI:1.200～3.505）,smoking in the first trimester（OR=3.481 95%CI:1.409～8.602）were the risk factors affecting sleep quality in the second trimester.Pregnant women who were overweight during pregnancy had a higher risk of poor sleep quality compared with normal-weight women（OR=3.023 95%CI:1.432～6.382）.Previous pregnancy history（OR=2.020 95%CI:1.248～3.268）and constipation（OR=1.69795%CI:1.046～2.754）were risk factors affecting sleep quality in the third trimester.Premarital examination（OR=0.598 95%CI:0.375～0.955）was the protective factor affecting sleep quality during pregnancy.Noise（OR=2.082 95CI%:1.148～3.775）was the risk factor affecting the quality of sleep during pregnancy.4.Analysis of sleep quality and common pregnancy complications during pregnancy Poor sleep quality in the first trimester was associated with umbilical cord around the neck（c²=6.162,P<0.05）,and there was no significant correlation between poor sleep quality in the three trimesters and common pregnancy complications（pregnancy-induced hypertension,preeclampsia,gestational diabetes,fetal distress,premature rupture of membranes,premature delivery,macrosomia）（all P>0.05）.ConclusionsThe second trimester of pregnancy has the lowest PSQI quality,and the incidence of poor sleep quality is the lowest.Sleep quality during pregnancy is affected by many factors.We should pay more attention to the sleep status of pregnant women with different characteristics,encourage premarital medical examination,maintain normal weight before pregnancy,maintain regular defecation,maintain a good sleep environment,eugenism,and reduce second-hand smoke exposure.It may help to improve the sleep quality of pregnant women and reduce the related complications.